Confidential memo from Simon Harris says final bill for the facility could be €1.73bn

Projects that may be shelved include new laboratories and theatres at the Coombe hospital, and a €3.4m investment in paediatric and blood services.

Key health service investments including additional hospital beds, new emergency, cancer and cardiac facilities, primary care centres and long-term residential units could be shelved for up to five years due to the escalating cost of the new National Children’s Hospital, a confidential report for the Cabinet states.

The total bill for developing the facility at St James’s Hospital is now expected to be more than €1.73 billion, an internal memo for Government drawn up by Minister for Health Simon Harris shows.

This is €300 million more than the construction costs cited by Taoiseach Leo Varadkar in the Dáil this week. The overall cost could rise even further – by up to €145 million – in the years ahead, the memo warns.

Mr Harris told Ministers that given the escalating costs, a series of planned healthcare projects “would have to be halted or significantly curtailed for up to five years to contribute towards the funding increase for the new children’s hospital project in 2019 within the existing capital plan allocation”.

Ministers were given a list of projects, including a €10 million development of extra hospital beds in Limerick, a €56 million investment in 90 long-term residential care facilities for older people in 11 counties and primary care centres in Clondalkin, Sligo and Monaghan that could be affected by the need to fund cost overruns at the new hospital.

Blood services

Other projects that may be shelved include the development of accommodation in the community for people with disabilities moving out of institutions, new laboratories and theatres at the Coombe hospital, and a planned €3.4 million investment in paediatric and blood services.

It also suggested the second cath lab at University Hospital Waterford and planned new emergency department and cystic fibrosis facilities at Beaumont Hospital in Dublin could be affected.

The Cabinet was told that while an additional €99 million would be needed to fund the new children’s hospital project next year due to the rising costs, even larger additional amounts will be required in future years, including €120 million in 2021 and €150 million in 2022.

“To fund such a quantum over the four-year period would in effect mean that there would be no development of appraisals and early planning for Slaintecare/capacity projects in the years 2019-2022.”

Mr Harris said the total cost of the development to 2023 was now estimated at €1.73 billion. This covers the building of the hospital and satellite urgent care centres in Tallaght and Blanchardstown, ICT and electronic health records facilities, a new research centre, the bill for integrating the existing three children’s hospitals and money spent on an aborted earlier attempt to build the facility at the Mater Hospital.

Total figure

The core €1.433 million construction price “may not be the total figure which will be payable for this construction project”, Mr Harris also warned. Construction inflation after 2019 could add €50-135 million, and the provision of accommodation a further €10 million.

The memo says the hospital project board had concluded in a report that “original estimates [for the hospital] should have been more reflective of the scale and complexity of the project relative to the capacity of the Irish construction market on a difficult congested site in a city centre location, and that a more robust early warning process during the design development phase was required”.